OmarChughtai.com

Life – Under the Microscope

A Doctor Must Care

It was 11 years ago today. The time was around 3 pm. In the blistering heat of the Lahore sun, a small crowd of us hopefuls gathered at King Edward Medical College. We were there to get our result for the Final Professional examination. This would be the day we would find out if we had become doctors!

And then it happened. Clutching a sheet of paper in his right hand, one of our class fellows emerged from the clerk’s office. Pushing and shoving, the crowd gathered around him as he read aloud the contents of that fateful results sheet. One by one he would read out a roll number and then the marks scored. Every once in a while, the total marks would be followed by the name of a subject, thus delivering the crushing news of a failed examination to the person in question. One by one he read out the roll numbers. Unable to wait, I climbed over someone’s shoulders to try to see my result for myself. I caught a glance of my roll number, and on the second attempt I saw the result as well. I had passed! I was a doctor! A student no more! The rest of that day is a foggy memory of celebrations and ‘mithai’ and parents crying with joy.

Looking back, that unceremonious announcement of the MBBS exam result was in fact quite appropriate. It is clear to me now that becoming a doctor is a journey and not a destination. That day, when the result was announced, we were only just beginning on our own individual journeys of house jobs, qualifying exams, night calls, specializations and even more exams. What’s more, we were yet to feel the immense burden of a patient’s hopes and expectations.  Experience teaches many lessons, and we had plenty to learn. Today, a decade later, many of the young doctors from that day have met with professional success.  They are spread all over the world, with a varied and impressive collection of post-graduate degrees. Some are working towards their post-graduate degrees, and some, who decided not to pursue post-graduate degrees, have built busy general practices.

All of this would be great, except for one tiny detail. Somewhere along the way many of us developed an attitude of entitlement. All of that suffering, all of those night calls and 30 hour duties should count for something after all. Unfortunately that entitlement and the arrogance that ensues is often the beginning of the end. The most important lesson, the one not taught often enough in medical college, is that more than all of our qualifications, the thing that matters most is that we actually listen to our patients. The degrees decorating the walls of our offices mean nothing to our patients if they are not accompanied by attention, compassion and care. It is this bond of trust between the doctor and the patient which must be built and strengthened with every interaction. Only then can we expect our patients to give us the respect that we think our qualifications and hard work entitle us to.

 

Missing the Diagnosis – One Fine Doctor at a Time

Ok. I give up!

I know I said that doctors care. And they do. At least most of them do. But then there are some who are either too incompetent or Ok. I give up. I know I said that doctors care. And they do. At least most of them do. But then there are some who are either too incompetent or too ignorant or just too damn arrogant to admit even to themselves that they don’t know what the heck is really going on with their patient.

I saw a patient yesterday who has seen at least 5 different doctors in Bahawalpur and Multan in the last two months. After two months of looking for answers for his poor health, all he has for a diagnosis is anemia (Low Hemoglobin.) Someone performed an ultrasound exam a week ago, and declared that his abdominal organs are all normal.

Here’s the thing. No one performed a physical exam on him. Not one of the doctors that he has seen in the last two months managed to see that he has an enlarged liver, an enlarged spleen and enlarged lymph nodes all over! A final year medical student could tell you that it looks like the patient has lymphoma. But not these five practitioners of the art of healing. As for the ultrasound, I wonder if the machine was even turned on when the exam was being performed.

I said last week that most doctors do care for their patients. They do try to get it right. And sometimes, being human, they make mistakes. I know I make mistakes every day. Show me someone who says he doesn’t make mistakes and I’ll show you a lier. In this case however, it wasn’t one mistake. It wasn’t one doctor. One after another, five different doctors failed this patient. And I can’t defend that.

Doctors – Living on the Edge

Much is made these days about how callous doctors have become. How selfish and arrogant and dis-engaged they are from their patients.They charge exhorbitant fees and pay only passing attention to their patients’ conditions. They get rich while the poor patients suffer.

All of that is true. Partly. It describes many doctors I know. In fact, in a general sense, it describes a lot of people I know. So I have concluded two things:

1. I should get to know better people.

2. Doctors are human. And they are a part of the same society we all are. They have the same qualities and the same faults that anyone else has.

Now I have to admit that I am a little biased. I myself am a doctor.  But my biased view also gives me a very close look at many of my colleagues who work very hard to get it right. As a pathologist I regularly interact with several doctors in a day. Most of the doctors I talk to are not only interested in their patients’  diagnosis, they are also deeply moved by it. They try hard to get it right. They are by no means perfect. But they are still a lot better than you might think.

Lately a doctor’s life has become rather dangerous. Every patient and every case has the potential to explode, and doctors find themselves living on the edge. Every day patients threaten their doctors with ‘media’ and ‘Geo.’ Just yesterday a patient threatened to break windows in my lab because he thought his results were incorrect. It has become common practice to cite ‘negligence’ by the doctor whenever a patient dies. Regardless of medical facts and circumstance, the cause of death in far too many cases these days is ‘the doctor.’ Never mind that the patient was 78 years old and had terminal cancer. Or that the patient was brought to the doctor in a critical condition, past the point of no return.

A few weeks ago a highly respected critical care physician was beaten up by the attendants of a deceased patient. And I am not talking about pushing and shoving. He and his junior doctor and his nurse and the ICU attendant were all beaten up. It was 2 in the morning, and the doctor had been called in to the hospital in the middle of the night because the patient was considered critical. The doctor was at the bedside when the patient died. The doctor did all he could, but he could not arrange a miracle. And that was the fault for which he and his staff were all physically abused.

As a doctor, as a Pakistani, as a person, I think this is utterly disgusting.  I know that there are many sides to many stories, but aren’t some things off the table. Aren’t some things too extreme. When did we become so ‘jaahil.’

 

 

I’ve seen this movie before

It’s been a week now, and it’s almost like nothing of consequence happened.

The day US Special Forces conducted a pre-dawn operation in Abbottabad, Karachi was on fire too. Somebody had shot dead a local MQM leader, and there were angry protests all over the city. Cars were burned. Gas stations stopped selling CNG and petrol. Thousands of people were stranded on the streets of Karachi, forced to abandon their vehicles and walk home.

While all this was happening, the government of President was hard at work doing nothing of consequence. The President was swearing in more ministers for the federal government, a political ploy meant to appease PML-Q and isolate PML-N. The indifference to the misery of the common man was plain for all to see.

Now let me be clear; I could not care less about PML or PPP or MQM or PTI or any other political party. What I am talking about is the lack of leadership on display on the morning of Osama’s death. While the media is all hot and bothered about Pakistan’s sovereign air space being violated, the harsh reality that must be faced is that there is a vacuum of leadership in our country.

I am not even talking about one incident. Or one government.

While a third of the country was dealing with floods last year, the President went to the UK to launch his son’s political career.

While the army moved to conduct an operation against the ‘Taliban’ two years ago, neither the President, nor the Prime Minister spoke to the nation about the unprecedented but necessary move of the Pakistan Army taking on Pakistani civilians.

And when Pakistan air space had been breached, the operation completed, and Osama found and killed in Pakistan, the powers that be were caught completely dumbfounded, clueless as to what spin to put on their incompetence.

I have seen this movie before. While foreign forces toyed with our so called sovereign status, the corridors of power were pre-occupied with palace intrigue. Two hundred years ago, no one saw the East India Trading Company as a threat to the monarchy until it was too late. We all know how that movie ended. And today, while our nation’s resources are completely used up, and our country survives from one foreign handout to the next, our ‘leaders’ are just as indifferent  as the Mughal kings of the past.

Time has passed, but the story is the same. Unless we change the script now, we know how this movie will end.

Sovereign Nation?

A lot is being made of Pakistan’s status as a sovereign nation.

How dare the US conduct drone attacks inside Pakistan’s territories.

How dare the US conduct a special op in Abbottabad.

We are after all a ‘sovereign’ nation!

 

But are we truly sovereign?

Do we pay our own bills?

Do we produce enough food to feed all of us?

Do we generate enough electricity for our needs?

Do we . . . . do anything that would merit sovereign status?

Sovereign states don’t go begging for handouts. They don’t survive on foreign aid.

 

Pakistanis love to say that the ‘West’ doesn’t want Pakistan to rise as a nation.  As if the ‘West’ goes to bed every night in fear of what Pakistan might accomplish if it were to get its act together.

I want to ask all of us Pakistanis. What are we doing to make Pakistan rise as a nation.

Forget the ‘West!’ Forget everyone else.

A nation’s destiny is either written by its own people, or dictated by others.

So if you don’t like what is being dictated, start working. Start writing.

And shape Pakistan’s future yourself!